%%
%%	$Id: rx.tex 2360 2005-12-29 16:48:26Z jeff $
%%	$Author: jeff $
%%
%%	FreeMED TeX Template
%%	Prescriptions
%%

\documentclass{article}

% No normal header, footer, etc
\usepackage[nohead,nofoot]{geometry}
% Relative size package
\usepackage{relsize}

% Magic to allow including EPS files
\ifx\pdfoutput\undefined
\usepackage{graphicx}
\else
\usepackage[pdftex]{graphicx}
\usepackage{epstopdf}
\fi

\begin{document}

\framebox[5in]{
	\parbox{4.8in}{
		\begin{center}
			{\relsize{1}\textbf{**link:rxphy:physician:phypracname**}} \\
			{\relsize{-1}\textsl{**method:Physician:fullName:rxphy**}} \\
			\textsl{**link:rxphy:physician:phyaddr1a**, **link:rxphy:physician:phycitya**, **link:rxphy:physician:phycitya** **link:rxphy:physician:phyzipa**} \\
			\textsl{Phone **link:rxphy:physician:phyphonea:phone** Fax **link:rxphy:physician:phyfaxa:phone**}

		\end{center}
		\begin{center}
			\begin{tabular}{r|l}
				\textbf{Patient} & **link:rxpatient:patient:ptfname:fixcase** **link:rxpatient:patient:ptmname:fixcase****if:linkexists:rxpatient,patient:ptmname**.**fi** **link:rxpatient:patient:ptlname:fixcase**   \\
			 	\textbf{Date of Birth} & **link:rxpatient:patient:ptdob:date** \\	
			 	\textbf{SSN} & **link:rxpatient:patient:ptssn:ssn** \\	
				\textbf{Account \#} & **link:rxpatient:patient:ptid** \\
				\  & \  \\
				\textbf{Rx Date} & **field:rxdtfrom:date** \\
				\  & \  \\
				\textbf{Address} & **link:rxpatient:patient:ptaddr1:fixcase** \\
				\  & **link:rxpatient:patient:ptcity:fixcase**, **link:rxpatient:patient:ptstate** **link:rxpatient:patient:ptzip** \\
				\  & \  \\
%				\textbf{Medication}  & \parbox{3in}{{\large **field:rxform** **field:rxdrug** **field:rxsize** **field:rxunit**}} \\
				\textbf{Medication}  & {\large **field:_drug** } \\
				\textbf{Disp} & **field:_dispensed** \\
				\textbf{Sig} & \parbox{3in}{**field:rxdosage**} \\
				\  & \  \\
				\textbf{Refill} & **field:_refills** refill(s) \\
			\end{tabular}
		\end{center}
		\ \\
		\centerline{\textbf{Notes} \  \parbox{4in}{**field:rxnote**} } \\
		\ \\
		\centerline{\textbf{**field:rxsubstitute**}}
		\ \\
		\hfill \\
		\centerline{{\large \textbf{**method:Physician:fullName:rxphy**}}} 
		\centerline{{\relsize{-1}DEA \#: **link:rxphy:physician:phydea**}}
		\centerline{{\large Signature On File}} 
%		\hfill \\
%		\centerline{{{md5}}}
	}
}

\end{document}
